New tax strategy for attracting and retaining doctors in Hawaii

Recently, the Hawaii Physician Workforce Assessment Project estimated that Hawaii is short over 700 full-time-equivalent physicians.

The decline in the number of healthcare workers is not a new problem, though. Most recent factors contributing to the shortage include physicians retiring and long work hours and burnout.

The greatest need is in primary care but there are also significant shortages in specialty care.

In the past, the state has implemented recruiting efforts to bring more physicians to Hawaii ranging from loan repayment programs to scholarships. But making it more profitable to be a doctor in Hawaii is one strategy that remains unexplored.

Not-for-profit facilities such as hospitals are exempt from Hawaii’s general excise tax (GET), but private practice physicians are taxed on their gross receipts making GET a significant overhead expense that makes it hard for private practice physicians to turn a profit. The medical community has cited the tax as a burden on local practices and a contributor to the state’s physician shortage.

If all for-profit medical providers were exempted from the general excise tax, would it result in enough savings to fill the physician shortage?

The Grassroot Institute of Hawaii released a policy brief exploring the possible outcomes of exempting all medical services from the GET tax. Read more about it here.

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